PSYCH 039: Neuropsychiatric Aspects of HIV Infection and AIDS

HIV is not only an infection of the immune system - it is also a disease of the brain. This chapter explores how HIV and AIDS affect the central nervous system, producing a spectrum of neuropsychiatric manifestations that evolve across the course of illness.In this episode, we examine how HIV enters the brain early in infection, leading to chronic neuroinflammation and neuronal injury. Even in the era of effective antiretroviral therapy, these processes can result in cognitive, behavioural, and emotional changes.We explore HIV-associated neurocognitive disorders (HAND), ranging from subtle cognitive slowing to more severe impairment. Alongside this, mood disorders, anxiety, psychosis, and behavioural changes may emerge - shaped by both biological and psychosocial factors.A key theme is interaction. The neuropsychiatric presentation reflects not only direct viral effects, but also immune status, treatment factors, comorbid conditions, and the psychological impact of living with a chronic illness.This chapter highlights the importance of integrated care - where neurological, psychiatric, and medical perspectives are combined to understand and manage the patient holistically.HIV reminds us that brain and body cannot be separated - and that systemic illness often finds expression in the mind.Key Takeaways* HIV affects the brain early and can lead to chronic neuroinflammation.* HIV-associated neurocognitive disorders range from mild to severe impairment.* Neuropsychiatric features include cognitive, mood, and behavioural changes.* Antiretroviral therapy improves outcomes but does not eliminate all effects.* Presentation is shaped by biological, treatment-related, and psychosocial factors.* Integrated, multidisciplinary care is essential.* Systemic illness can manifest as changes in mental function and experience. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe